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输注ABO血型不匹配的血小板不会影响接受自体造血干细胞移植患者的临床结局。

Transfusion of ABO non-identical platelets does not influence the clinical outcome of patients undergoing autologous haematopoietic stem cell transplantation.

作者信息

Solves Pilar, Carpio Nelly, Balaguer Aitana, Romero Samuel, Iacoboni Gloria, Gómez Inés, Lorenzo Ignacio, Moscardó Federico, Sanz Jaime, Lopez Francisca, Martin Guillermo, Jarque Isidro, Montesinos Pau, De La Rubia Javier, Sanz Guillermo, Sanz Miguel A

机构信息

La Fe University Hospital, Valencia, Spain.

出版信息

Blood Transfus. 2015 Jul;13(3):411-6. doi: 10.2450/2015.0195-14. Epub 2015 Feb 2.

Abstract

BACKGROUND

There are ABO antigens on the surface of platelets, but whether ABO compatible platelets are necessary for transfusions is a matter of ongoing debate. We retrospectively reviewed the ABO matching of platelet transfusions in a subset of patients undergoing autologous haematopoietic progenitor cell transplantation during a 14-year period. Our aim was to analyse the characteristics and outcomes of patients who received platelet transfusions that were or were not ABO identical.

MATERIAL AND METHODS

We analysed 529 consecutive patients with various haematological and non-haematological diseases who underwent 553 autologous progenitor stem cell transplants at the University Hospital la Fe between January 2000 and December 2013. We retrospectively analysed and compared transfusion and clinical outcomes of patients according to the ABO match of the platelet transfusions received. The period analysed was the time from transplantation until discharge.

RESULTS

The patients received a total of 2,772 platelet concentrates, of which 2,053 (74.0%) were ABO identical and 719 (26.0%) ABO non-identical; of these latter 309 were compatible and 410 incompatible with the patients' plasma. Considering all transplants, 36 (6.5%) did not require any platelet transfusions, while in 246 (44.5%) cases, the patients were exclusively transfused with ABO identical platelets and in 47 (8.5%) cases they received only ABO non-identical platelet transfusions. The group of patients who received both ABO identical and ABO non-identical platelet transfusions had higher transfusion needs and worse clinical outcomes compared to patients who received only ABO identical or ABO non-identical platelets.

DISCUSSION

In our hospital, patients undergoing autologous haematopoietic stem cell transplantation who received ABO identical or ABO non-identical platelet transfusions had similar transfusion and clinical outcomes. The isolated fact of receiving ABO non-identical platelets did not influence morbidity or survival.

摘要

背景

血小板表面存在ABO抗原,但输血时ABO血型相容的血小板是否必要仍存在争议。我们回顾性分析了14年间接受自体造血祖细胞移植的部分患者血小板输注的ABO血型匹配情况。我们的目的是分析接受ABO血型相同或不同的血小板输注患者的特征及结局。

材料与方法

我们分析了2000年1月至2013年12月期间在拉费大学医院接受553例自体祖细胞干细胞移植的529例患有各种血液系统和非血液系统疾病的连续患者。我们根据所接受的血小板输注的ABO血型匹配情况,对患者的输血及临床结局进行回顾性分析和比较。分析的时间段为从移植至出院。

结果

患者共接受2772单位血小板浓缩物,其中2053单位(74.0%)ABO血型相同,719单位(26.0%)ABO血型不同;在后者中,309单位与患者血浆相容,410单位不相容。考虑所有移植病例,36例(6.5%)不需要任何血小板输注,而在246例(44.5%)病例中,患者仅接受ABO血型相同的血小板输注,47例(8.5%)病例中患者仅接受ABO血型不同的血小板输注。与仅接受ABO血型相同或不同血小板输注的患者相比,同时接受ABO血型相同和不同血小板输注的患者组有更高的输血需求和更差的临床结局。

讨论

在我们医院,接受ABO血型相同或不同血小板输注的自体造血干细胞移植患者有相似的输血及临床结局。接受ABO血型不同血小板这一孤立事实并未影响发病率或生存率。

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